Healthcare Provider Details

I. General information

NPI: 1699630723
Provider Name (Legal Business Name): KAYLA CROWDER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8721 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1803
US

IV. Provider business mailing address

8721 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1803
US

V. Phone/Fax

Practice location:
  • Phone: 702-544-7776
  • Fax:
Mailing address:
  • Phone: 702-544-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95202789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: